Lifestyle Occupational Therapy, PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

012318 Issued in NY

Legal business name

LIFESTYLE OCCUPATIONAL THERAPY, PLLC

Practice address

101 1St St
Liverpool, NY 13088-5108

Phone

(315) 422-8822

NPI assigned

May 18, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David P. Grover, OTR L

Title

Owner

Phone

(315) 422-8822

Specialties & licenses 2

Addresses

Other names 1

• David Grover OTR L Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1740509694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 DEWITT ST #2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13203",
            "telephone_number": "315-422-8822",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 1ST ST",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885108",
            "telephone_number": "315-422-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE OCCUPATIONAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2013-10-31",
        "status": "A",
        "authorized_official_last_name": "GROVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-422-8822",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR L"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "007946",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David Grover OTR L",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Occupational Therapist in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.